From Lumpectomy to Mastectamy

My Mom is 63, had inductal breast carcinoma, had a lumpectomy but when analysed they saw they had sliced through the 1.1cm malignant tumour. It was near the surface with a lot of swelling. That was last week and now tomorrow, 7 days later, she must have a mastectamy. The tumour was near the surface and she is a 38DD. I am just wondering if it could have spread rapidly to the lymph nodes after they sliced through it and should she not just have had a mastectamy in the first place to avoid that spread? Did they leave it too long after slicing it? Also if we find it has spread to her lymph nodes what are her chances of survival and for how long? If it has not spread what is the prognosis?

Thanks
Mary

[CCF-RN,MSN-rf]

Dear mab: From what you are saying, I am guessing that the surgical margins are positive.  That is, there are cancer cells present at the edges of the lumpectomy.  In cases like this, it is not uncommon to do a mastectomy if a good cosmetic result cannot be obtained with another lumpectomy or if the cancer has features best addressed by mastectomy.  It is unlikely that the surgery caused any spread to the lymph nodes, although these should be checked regardless of whether the procedure is a lumpectomy or mastectomy.  Your mothers prognosis will be determined by the size of the tumor, whether or not there are positive lymph nodes and how many nodes are positive, as well as some other tests they will perform on the tumor.  In any case, people with breast cancer generally do very well.